Polodoc: Squeezed, Rotated, Fractured

Dr.med. Andreas Krüger is a Swiss board orthopaedic and trauma surgeon in Zurich, who specialises in knee and shoulder surgery. Andi is a second generation of tournament doctors for equine sports, known as Polodoc since 2013

Squeezed, Rotated, Fractured

Damage control technique

Lately, many famous professional polo players faced season-ending injuries on the field. In most cases a combination of impact from the horse with the speed of the game plus the height of the fall result in massive impact on anatomical structures. The consequence is that fractures of the bone, rupture of the ligaments and damage to the soft tissue are common occurrences. A total recovery is possible, but the journey maybe long and small mistakes in the initial treatment can tremendously impact the final result and the time to safely return to play.

Mechanism of Injury

During polo a player can be squeezed in between several horses with a weight of up to 1,000 pounds falling on the ground. This is a unique situation in sport injuries. Most likely additional impact results from rotation which is a condition when the fall is combined with impact. When these forces impact the human body, a certain threshold leads to fractures of the bone and rupture of ligaments. The surrounding soft tissue is like an envelope. An intact envelope is important for wound healing after an operation and protection of the bone from contact to the contaminated outside environment.

First Response

In case of open fracture (where bone is exposed to air) a primary sterile dressing would be excellent and direct transfer to a

A pre-operative X-ray of an open fracture

In the hands of experienced surgeons, damage control surgery and advanced treatment techniques can positively affect the final outcome

A post-operative X-ray of a lower fracture. Post-operative images of the surgery site

In total coherence with the patient’s heart rate, Stendo ® produces pulsatile compression forces that dynamically and systemically stimulate the veno-lymphatic functions and mobilise the superficial tissues. This dual action also makes it possible to effectively regulate the inflammation and to act on the pain.

specific ortho trauma center. When a direct transfer is not possible, try to add some stability with external bracing and plan transfer. Closed fractures and ligamentous injuries can be treated with less urgency. But CLUB PHONE EMAIL when a strong deformity or impact is present, All Ireland Polo Club 00353 01 6896732 dstone@indigo.ie direct swelling and hematoma may influence the primary treatment in the hospital. All England Polo Club Hickstead* 01273 834 315 polo@hickstead.co.uk Apsley End Polo Club* 01462 712444 tobiana.scott@gmail.com Ash Farm Polo Club* 07799 812739 ashfarmpolo@hotmail.com Barfold Polo Club 07778 808853 mborwick@gmail.com Diagnostics Bawtry Polo Club Beaufort Polo Club 01302 773282 01666 880510 info@bawtrypoloclub.co.uk enquiries@beaufortpoloclub.co.uk

CLUB

Home Farm Polo Grounds Hurtwood Polo Club Kirtlington Park Polo Club Knepp Castle Polo Club Leadenham Polo Club Longdole Polo Club* Moor Farm Polo Club

Polo directory

PHONE

EMAIL

07807672120 rachaelkearnet@hotmail.co.uk 01483 272828 polo@hurtwoodparkpolo.co.uk 01869 350138 info@kirtlingtonparkpolo.co.uk 07920 023639 info@aspectpolo.co.uk 07429 299026 offi ce@leadenhampoloclub.com 01452 864544 info@longdolepolo.com 07494 114190 shop@moorfarmshop.co.uk

The initial clinical examination is crucial. Soft tissue injuries of the lower extremity need documentation for later follow-up and early inclusion of a plastic surgeon is recommended. X-ray basic analysis should always be carried out. When additional injuries are suspected, initial full assessment with cross sectional images like CT and MRI should be considered.

Recovery

When initial treatment is successfully executed then the second line of treatment starts. Many little helpers can elevate the overall result and can limit the time to return in the saddle. Beginning with nutrition supplements over continuous passive motion machines or electric muscle stimulation and ending with transdermal soft tissue improving devices – lots of tuning can be done to speed up recovery and performance.

Outlook

In the hands of experienced surgeons, damage control surgery and advanced treatment techniques can tremendously impact the final outcome. New tools combined with well-approved surgical techniques in the hand of an expert are crucial to minimise the risk for complications.

Beverley Polo Club* 01964 544877 info@beverleypoloclub.co.uk Binfi eld Heath 01491 411969 bhpcmanager@gmail.com Blueys Polo Club* 07930 323263 polomanager@blueyspolo.co.uk Bramham Polo Academy 07811 993316 emmadvh@btinternet.com Bunclody Polo Club 00353 87 6605917 info@poloclubbunclody.com Burningfold Polo Club 01483 200722 derrek@burningfold.com Cambridge Polo Club* 07711 217004 cambridgepoloclub@icloud.com Cambridge County Polo Club* 01223 812922 info@cambridgecountypoloclub.co.uk Carlton House 07901 561113 harrietservaes@hotmail.com Chester Racecourse Polo Club 01244 304602 amorris@chester-races.com Cheshire Polo Club 01948 861020 info@cheshirepoloclub.co.uk Chiltern Polo Club 07973 174542 info@chilternpoloclub.com Cirencester Park Polo Club 01285 653225 info@cirencesterpolo.co.uk Cowdray Polo Club 01730 813257 enquiries@cowdraypolo.co.uk Curraghmore Polo Club 00353 51 387102 mkennedy@cssgroup.ie Dallas Burston Polo Club* 01926 811 111 enquiries@ixlevents.com Dorset Polo Club 01202 623985 offi ce@dorsetpolo.co.uk Druids Lodge Polo Club* 01722 782597 abi@druidspolo.co.uk Dundee and Perth Polo Club* 07831 365 194 jamesscrawford@aol.com Eastwood Polo Club 07875 743475 frankums@googlemail.com Edgeworth Polo Club Edinburgh Polo Club* 01285 821695 07971 072336 edgeworthpolo@gmail.com james.dgls@gmail.com For more information Emsworth Polo Grounds* 01344 883112 info@fourquarterspolo.co.uk on Polodoc contact Epsom Polo Club* 07961 232106 epsompoloclub@hotmail.com Andreas Krüger at FHM Polo Club* Fifi eld Polo Club* 07778 436468 01628 620061 frances@fhmpolo.co.uk fi fi eldpoloclub@live.co.uk drmedkrueger@gmail.com Great Trippetts Polo Club 01428 741916 charles@trippetts.com or www.polodoc.chGuards Polo Club* 01784 434212 polo@guardspoloclub.com Ham Polo Club 020 8334 0000 offi ce@hampoloclub.com Hertfordshire Polo Club* 01707 256023 polo@hertspolo.co.uk Moor Hall Farm Polo Club* 01279 450637 alecbeve@btinternet.com New Forest Polo Club 07977 224404 annabelparryjoyner@yahoo.co.uk Norfolk Polo Club 01508 480400 offi ce@norfolkpolo.co.uk Northern Ireland Polo Club 07803 020577 info@northernirelandpoloclub.co.uk Offchurch Bury Polo Club* Pangbourne Polo Club 07816 830887 07708 906810 Advertising info@offchurchburypoloclub.co.uk aprice@polofi x.com Polo directoryPeover Polo Club 07766 016 833 polomanager@peoverpoloclub.co.uk Polo Wicklow* 00353 404 67164 siobhan@polowicklow.com RAF Cranwell 07739 569491 rafcranwellpoloclub@yahoo.co.uk Ranelagh Polo Club* 01344 885697 ranelagh@labravapolo.com RCBPC* 01344 890060 polo@rcbpc.com RMAS Polo Club 07973 174542 rmas-nc-aci-projinters@mod.uk Rugby Polo Club* 01788 817724 info@rugbypoloclub.com Rutland Polo Club 07772 040668 secretary@rutlandpoloclub.co.uk Silver Leys Polo Club 07730 060200 silverleyspoloclub@gmail.com St. Albans Polo Club 07956 017090 info@stalbanspoloclub.co.uk Stewarton Polo Club 07974 706045 info@stewartonpolo.co.uk

Special occasion polo cards for Suffolk Polo Club 07990 576974 aes3@cam.ac.uk birthdays, anniversaries, get well soon, Sussex Polo Club* Taunton Vale Polo Club 01342 714920 01823 480460 info@sussexpolo.co.uk nhs.wheelers@gmail.com weddings, & baby congratulations; Tidworth Polo Club* 01980 846705 info@tidworthpolo.com from £2.99 plus p&p Toulston Polo Club Triskelion Polo Club* 07776 234638 07624 272547 info@toulstonpoloclub.com polo@triskelionpolo.club Vale of York Polo Club* 07788 426968 info@valeofyorkpoloclub.co.uk

Visit www.Katesart.com Vaux Park Park Polo Club* West Wycombe Park Polo Club* 07703 524613 07787 560729 vppc@btconnect.com secretary@westwycombepolo.co.uk or txt/tel 07887 678421 Westcroft Park Polo Club* 01276 858545 info@westcroftparkpolo.co.uk or email: enquiries@Katesart.com White Rose Polo Club* White Waltham Polo Club 01430 875767 07748 670587 info@whiterosepolo.co.uk kim@playpolo.co.uk image copyright protected by Katesart.com 2007 * Also open for arena polo in the UK winter

Executive helicopter charter service

Heli Air can make your day at a polo match an even more memorable experience. Fly by helicopter to the events of your choice, from wherever you live or are staying, on the day with speed and comfort. Heli Air Head Office • Warwick • CV35 9EU Also at: Wycombe, Silverstone, London/Denham, London/Fairoaks, Thruxton and Gloucestershire Airport 01789 470476 • HeliAir.com • Charter@HeliAir.com